Individual
MALLORY LYNN DAMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
510 W 7TH ST, ELLINWOOD, KS 67526-1101
(629) 564-2337
Mailing address
215 S WASHINGTON AVE, GREAT BEND, KS 67530-9657
(620) 639-1819
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1403411
KS
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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